A case report of invasive candidiasis and fungal osteomyelitis mimicking oropharyngeal carcinoma recurrence in an immunocompetent patient following transoral robotic surgery

Abstract

HighlightsTORS for oropharyngeal tumour may predispose susceptible patients to invasive fungal infection and osteomyelitis.Susceptible patients included those with prior history of radiation at surgical site.Fungal infection can present as an exophytic mass at the surgical site.

Skull base or cervical vertebral osteomyelitis following chemoradiotherapy for pharyngeal carcinoma: A serious but treatable complication

“…The pathogenesis of osteomyelitis and in particular, vertebral osteomyelitis, may be precipitated by haematogenous seeding from a distant infected area, direct inoculation from trauma or invasive procedures, or contiguous spread from an adjacent area of infection [9] . Radiation could also predispose patient to osteomyelitis due to radiation-induced stromal and vascular fibrosis resulting in increased risk of bacterial or candida colonization and infection on the adjacent mucosal membrane [10] . Treatment varies from non-invasive (e.g.…”

Transoral robotic surgery advantages and disadvantages: a narrative review

“… Pharynx [23–30] : This category includes the publications for TORS in pharynx [23–25], nasopharynx (NP) [26] – located to the upper part of the pharynx –, parapharynx space tumours [27, 28] – located deep within the neck and it is a potential space lateral to the upper pharynx – and retropharynx [29, 30] – which is the posterior part of the pharynx – (see Table 2). Oropharynx [1, 31–52] : This category includes all the publications related to TORS, which refer to oropharyngeal carcinomas and tumours. The first subcategory includes publications which present the outcomes following TORS for oropharynx squamous cell carcinoma (OPSCC), such as swallowing, speech and quality of life (QOL) [40], the oncologic and functional outcomes [39, 52], postoperative bleeding with and without external carotid artery ligation [44].…”

“…Also, another publication proposes a modified TORS approach in which transoral mandibular osteotomies are performed that can greatly improve exposure to oropharyngeal subsites and expand access to the larynx in selected patients [37]. The third subcategory included publications which present application of TORS for OPSCC [33, 51], such as a study from a Danish head and neck cancer centre that aims to demonstrate the feasibility of performing primary TORS and concurrent neck dissection [42], a review of utility of TORS for HPV negative OPSCC [45], a critical literature review on TORS, a presentation of a case in which successful visualisation and resection of an OPSCC is demonstrated using the novel Medrobotics® Flex®System [50], and a case of invasive candidiasis in an immunocompetent patient with previous radiation therapy (RT) years ago who underwent TORS [31]. The fourth subcategory includes publications which compare TORS with other surgical approaches [47, 48].…”